A Simple One-Hour Treatment Has Reversed Insomnia in 75% of Participants, Says New study

Other modes of treatment include psychotherapy, stress relieving techniques, chronotherapy and bright light therapy.

Pharmacologic treatment

  • Prescription medications

Medications are used as the first-line approach in many cases because of the limited availability of CBT-trained personnel and the need for personal interactive sessions. The sedation they cause reduces the arousal state, thus improving night sleep. They have adverse effects, however, which limits their long-term use in many cases. Ideally, they should be used to bring about a rapid improvement in sleep over the short term while the patient is learning to use CBT techniques.

Benzodiazepines are hypnotic drugs which have been used traditionally to induce sleep, because they reduce the sleep latency and increase sleep duration. Their long duration of action and significant residual sedation have been cause for concern. They may cause amnesia and respiratory depression in some cases, as well as having addiction potential. They also shorten REM sleep.

Nonbenzodiazepines include the sedative GABA-ergic agents such as zolpidem and the newer zaleplon which has a very short half-life (1.5 to 4 hours), as well as the melatonin receptor agonist trazodone. Zolpidem (especially in sublingual form) and zaleplon are given at bedtime to induce sleep in sleep onset insomnia because of their short duration of action.

Certain antidepressants which reduce the activity of the HPA axis have been used. These offer a better effect without rapid induction of tolerance, and have a better safety profile over the long term.

  • Over-the counter medications

Patients with sleep-onset insomnia have traditionally taken sedating antihistamines (diphenhydramine and doxylamine) to hasten sleep onset, but they quickly induce tolerance, and often leave the patient sleepy or less alert the next morning as well. This is also a serious potential drawback of the benzodiazepines. The lingering effects of impaired muscular reflexes and coordination, with slowing of memory and a sense of fatigue, have dogged the use of most of these drugs.

Alternative medications

Herbal preparations such as melatonin and valerian have been promoted for use in this condition primarily due to this concern. Melatonin is a hormone intimately concerned with the light-dark cycle and circadian rhythms, including sleep cycles. Its amount in the body is reduced due to the use of tobacco, alcohol, and many drugs. Its levels also go down with age. It is used to induce sleep by early evening administration, which advances the Circadian phase.

Valerian root, valeriana officinalis, is used for the central sedative action of its oil, which causes inhibition of GABA metabolism and induces sleep

Alcohol

Alcohol is used as an aid to sleep but in excess it may cause the nocturnal awakenings, besides its propensity to fill the bladder and cause the need to void. Moreover, it is very likely to cause addiction.

Pain relievers, such as anti-inflammatory drugs, may also help to treat chronic pain-related insomnia as well as reduce the hyper-arousal associated with insomnia.

PrevNext

Leave a Reply

Your email address will not be published. Required fields are marked *